Examine the role of the Registered Nurse (RN) role in the case study below, with particular emphasis placed on the legal, ethical and
professional nursing practice roles and responsibilities.
Your interpretation and examination of the key issues that occurred for the patient throughout his admission are to form part of your argument.
Reference is to be given to the Australian Nursing and Midwifery Council (ANMC) Competency Standards for the Registered Nurse, the ANMC Code of Ethics and the ANMC Code of Conduct. Comments on potential policy/procedural issues by the hospital in the case study are also to be included in your discussion.
Your argument is to be supported by references to contemporary, scholarly research, as well as to NSW Ministry of Health documents and policy.
The case study is to include an introduction and conclusion and headings are to be used to highlight and break-up the main points of discussion.
You should review the marking criteria so that you are clear on how marks are allocated to this assignment.
Mr Max Sheppard is a 64 year-old man who underwent a laparoscopic cholecystectomy at the large metropolitan Springfield hospital on the morning of 21 May 2013. Mr Sheppard was transferred to the Extended Day Only Unit (EDOU) at 1430 hours following the procedure. Mr Sheppard was to stay in the EDOU overnight with discharge planned for the following morning (22 May 2013).
A Medical Officer (MO) assessed Mr Sheppard at 1630 hours on 21 May due the patient reporting abdominal pain and distension. Mr Sheppard?s distended abdomen and pain levels were documented in the patient?s health record by the MO and a phone call was made to report this information to the surgeon who performed the procedure. Analgesia was prescribed (10mg morphine SC) at 1715 hours to be given PRN 6 hourly in response to the patient?s reports of pain.
Ms Sally Price was the RN working on the 12-bed EDOU with an Enrolled Nurse (EN) on 21 May. Ms Price had been registered as a nurse for five years. As per hospital policy, Ms Price and the EN were the only two staff members rostered to the unit on night-shift that commenced at 2245 hours.
The EDOU was at capacity on the night of 21 May. Two of the other male patients
admitted to the unit were distressed; one was continuously vomiting post-appendectomy and the other was experiencing urinary retention following a Transurethral Resection of the Prostate (TURP). There was also a female patient admitted to the unit who was very upset at being placed in a room with male patients due to her religious beliefs. This patient, who had very limited English language skills, was continually wailing and expressing anger over the fact that hospital management had not resolved this issue as promised to the patient and her husband on the afternoon shift.
It was hospital procedure that staff in the Post-Anaesthesia Care Unit (PACU), located adjacent to the EDOU; assist the EDOU staff when needed. The RN in-charge of the PACU on night-shift was required by hospital policy to ?regularly? check by phone with the EDOU RN to see if assistance was required. There was no such request made for assistance by Ms Price on the night of 21 May despite the fact the in-charge of the PACU reportedly contacted Ms Price five (5) times throughout the shift.
At 0210 hours on 22 May 2013, Ms Price documented the following in Mr Sheppard?shealth record:
?Temp 38.9, P 126, Resp Rate 16 and BP 110/72 (approx)?
These were the only observations documented during the night-shift. There was no
evidence of analgesia administration documented on Mr Sheppard medication chart by the time day-shift staff commenced work. The day-shift RN for 22 May did report that Ms Price had verbally stated that she had been ?flat out? all shift and had not finished her ?notes? by the time handover occurred.
At 0630 hours on 22 May, Mr Sheppard?s temperature was recorded by the day-shift RN as being 39 degrees, heart rate 140bpm and blood pressure 80/46mmHg. He was experiencing acute abdominal rebound tenderness and reported that his pain levels had rapidly increased throughout the early morning. At 0645 hours a PACE call was made. Mr Sheppard was ultimately returned to theatre where a perforated bowel was identified and successfully repaired.
1. Identification and examination of the legal registered nursing roles and responsibilities in case study .
2. Identification and examination of the ethical registered nursing roles and responsibilities in case study
3. Identification and examination of the professional registered nursing roles and responsibilities
4. Argument is supported by reference to the ANMAC documents and to NSW Ministry Health polices
5. Argument includes reference to potential policy/procedural issues by the hospital
6. Identification and examination of key events that occurred throughout the patient?s admission
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